Factors Associated with Measles Vaccine Drop-out Among Children Aged 12-23 Months in Selected Urban Slum of Dhaka

BackgroundMeasles vaccine dropout between the first (MCV1) and second dose (MCV2) remains a public health concern in Bangladesh, particularly in urban slum settings. Identifying factors associated with vaccine dropout is essential to improve coverage and achieve the national measles elimination target by 2026. ObjectiveTo identify factors associated with measles vaccine dropout among children aged 12-23 months in an urban slum of Dhaka, Bangladesh. MethodsA community-based case-control study was conducted in Korail slum, Dhaka, including 99 children (33 cases, 66 controls) selected purposively in 2023. Cases were children in Korail slum aged 12-23 months who received the first Pentavalent dose but missed MR1 or MR2; whereas the controls completed the measles vaccination schedule, matched by age and sex. Data on socio-demographic characteristics, healthcare access, and vaccination service experiences were collected using structured questionnaires. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with vaccine dropout. ResultsMean age of children was 16.2 months (SD {+/-}2.6). Children of homemaker mothers had higher odds of dropout than those of working mothers (AOR: 4.84; 95% CI: 1.72-13.63). Second-born children were more likely to drop out compared to first-born (AOR: 5.3; 95% CI: 1.86- 15.34). Longer waiting times before vaccination ([≥]15 minutes) were reported by 75.86% of cases versus 59.32% of controls. Other factors, including maternal education and household size, were not significantly associated. ConclusionMaternal occupation, birth order, and service-related factors influence measles vaccine dropout in urban slums. Targeted interventions such as flexible vaccination schedules, reducing waiting times, and engaging caregivers of multiple children are essential to improve coverage and support Bangladeshs measles elimination goal by 2026.